Information Collection

Video Relay Service Program

IC 231060 under ICR 201804-3060-004 · OMB 3060-1150.

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Information Collection (IC) Details

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IC Title:	Video Relay Service Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 47 CFR 64.604 47 CFR 64.606

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 36	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 10 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	206	0	206
Annual IC Time Burden (Hours)	589	167	422
Annual IC Cost Burden (Dollars)	12,000	12,000	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.